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FINALS > MS > Flashcards

MS Flashcards

1
Q

what is the pathophysiology behind MS?

A

inflammatory demyelination condition affecting CNS

plaques disseminated in time and place

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2
Q

what are the common sites for demyelination in MS?

A

optic nerve
spinal cord
cerebellum
peri-ventricular white matter

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3
Q

what are the main pathological findings in MS?

A

varying degrees of inflammation
peri-vascular inflammation and oedema
neuronal loss with reactive astrocyte gliosis

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4
Q

what is a very common symptom with MS?

A

lethargy

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5
Q

what are motor symptoms associated with MS?

A

pyramidal weakness

gait abnormalities

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6
Q

what are sensory symptoms associated with MS?

A

numbness/tingling

pain

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7
Q

what are cerebellar symptoms associated with MS?

A

incoordination (ataxia)
tremor
dysarthria

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8
Q

what are symptoms of the eyes in MS?

A 
sudden loss of vision
double vision (nystagmus)
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9
Q

what a are bowel/bladder symptoms in MS?

A

alteration to normal habits

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10
Q

what kind of motor neurone signs are seen in MS?

A

UMN:
spasticity
brisk reflexes
positive babinski

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11
Q

what signs are seen in the eyes?

A

nystagmus

RAPD - optic neuritis

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12
Q

what is Lhermittes phenomenon?

A

electric shock down spine and arms when head is bent forward

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13
Q

what is Uhtoffs phenomenon?

A

worsening of symptoms with heat and exercise

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14
Q

what is Hoffmans relfex?

A

flexion of thumb on tapping nail or flicking distal phalanx of middle finger

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15
Q

what is the most common subtype of MS?

A

relapsing and remitting

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16
Q

what is relapsing and remitting MS?

A

unpredictable relapses of varying severity with complete recovery seen

17
Q

what will most patients with relapsing and remitting go on to develop?

A

secondary progressive MS

18
Q

what is secondary progressive MS?

A

relapses with incomplete recovery and acute relapses superimposed
steady neurological decline and increased disability

19
Q

what is primary progressive MS?

A

steady neurological decline with no periods of remission following onset of symptoms

20
Q

what is progressive relapsing MS?

A

steady neurological decline from onset of symptoms with super imposed relapses

21
Q

what is the diagnostic criteria for MS?

A

2 episodes of symptoms suggestive of MS that last at least 1 hour and are at least 30 days apart
(shows dissemination in time and place)

22
Q

what investigations are used to diagnose MS?

A

auto antibodies
MRI
lumbar puncture
evoked potentials

23
Q

what is shown on MRI in MS?

A

identified optic neuritis

plaques of demyelination

24
Q

what is seen in lumbar puncture in MS?

A

oligoclonal bands of IgG

25
Q

what are evoked potentials? what is seen in MS?

A

time between visual stimulation and response in brain

delayed in MS

26
Q

what is the aim of management in MS?

A

reduce relapses

no cure

27
Q

what drugs are used in MS to treat spasticity?

A

1st line baclofen/gabapetin

physiotherapy

28
Q

what drugs are used to treat sensory symptoms?

A

amitriptyline

gabapentin

29
Q

what is used to manage bladder dysfunction?

A

bladder training

anti cholinergic - oxybutinin

30
Q

what is used in relapse management?

A

IV steroids - methylprednisolone

plasma exchange - plasmapheresis (to remove autoantibodies)

31
Q

what disease modifying drugs are first line in MS?

A

B interferon
capaxone (glitramer acetate)
tedfidera

32
Q

what are the side effects of b interferon?

A

flu like symptoms

depression

33
Q

what are the side effects of capaxone?

A

flu like symptoms

34
Q

what are the side effects of tecfidera?

A

progressive leukonecphalopathy

in JC virus positive patients

FINALS (25 decks)

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